Auto-HSCT bridging to CAR-T for follicular lymphoma transformed to B-lymphoblastic leukemia/lymphoma: report of 1 case and review of literature
10.3760/cma.j.cn115356-20230404-00082
- VernacularTitle:auto-HSCT桥接CAR-T治疗滤泡淋巴瘤转化B淋巴母细胞白血病/淋巴瘤1例并文献复习
- Author:
Xiangping ZONG
1
;
Hao NI
;
Jin ZHOU
;
Yutong LU
;
Shuangzhu LIU
;
Caixia LI
;
Depei WU
Author Information
1. 国家血液系统疾病临床医学研究中心 江苏省血液研究所 苏州大学附属第一医院血液科，苏州 215006
- Keywords:
Lymphoma, follicular;
Precursor B-cell lymphoblastic leukemia-lymphoma;
Hematopoietic stem cll transplantation;
Chimeric antigen receptor T-cell immunoth
- From:
Journal of Leukemia & Lymphoma
2023;32(11):662-666
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of autologous hematopoietic stem cell transplantation (auto-HSCT) bridging to chimeric antigen receptor T cell (CAR-T) immunotherapy for follicular lymphoma (FL) transformed to B-lymphoblastic leukemia/lymphoma (B-LBL).Methods:The diagnosis and treatment of 1 patient with FL transformed to B-LBL admitted to the First Hospital of Soochow University in August 2020 were retrospectively analyzed and the literature was reviewed.Results:The male patient was 65 years old, and was diagnosed as FL (stage Ⅳ group A, FL international prognostic index -1 score 3 points, high-risk group) in August 2020. And then he was given 6 courses of RB (rituximab combined with bendamustine) regimen, with complete remission (CR) at mid-term and end-stage PET-CT, followed by regular maintenance therapy with rituximab every 2 months, and disease progressed after 4 courses of maintenance therapy. According to the results of histopathology and bone marrow aspiration in December 2021, he was diagnosed B-LBL involving the bone marrow. Partial remission was achieved after induction therapy with zanubnulindb combined with hyper CVAD (cyclophosphamide + doxorubicin + vindesine + dexamethasone) regimen, followed by auto-HSCT bridging to CAR-T treatment targeting CD19 and CD22, which proceeded smoothly with cytokine release syndrome grade 0, immune effector cell-associated neurotoxicity syndrome grade 0. The patient successfully underwent hematopoietic reconstruction and orally taken ibrutinib after discharge. PET-CT indicated CR 2 months after transplantation and he was still in disease-free survival state.Conclusions:The prognosis of FL transformed to B-LBL is poor, and auto-HSCT bridging to CAR-T can improve the prognosis and prolong the survival time of patients who cannot undergo allogeneic hematopoietic stem cell transplantation.
